[Resection of the recurrent third branchial fistula under gastroscope with assistance of yellow zebra guidewire].

OBJECTIVE

To investigate clinical aspects and a new operative method for resecting third branchial fistula.

METHODS

The clinical aspects of 4 patients with third branchial fistula were retrospectively analyzed. It is difficult to locate the inner orifice of fistula through neck path due to tiny diameter of inner orifice. The inner orifice could be found and closed effectively by inserting yellow zebra guidewire from sinus piriformis with gastroscope. The mucous membrane of sinus piriformis could not be damaged due to the soft pointed end of yellow zebra guidewire.

RESULTS

4 cases were treated successfully without pharyngeal fistula or recurrent laryngeal nerve injury. No recurrent infections were found in all cases with follows-up of 6-66 months.

CONCLUSION

Ineffectiveness of radiography with meglumine diatrizoate or oral administration of methylene blue before operation indicates tiny fistula. In this case, resection of third branchial fistula with the assistance of gastroscope and yellow zebra guidewire under general anesthesia can be performed. This innovative method of diagnosis and treatment is worth of application clinically.